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Patient Care PGY1

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					                                                            PATIENT CARE: PGY-1
     Task                     Milestones                    Timeline   Remediation Plan                                    Goals to resolve Remediation
                  Synthesize all available data,                          Chart reviews of own cases with mentor              Completion of       essay type level appropriate
                  including interview, physical                           Chart reviews of clinic cases with clinic           case scenarios to the Program Director’s
                  examination, and preliminary                12          mentor                                              satisfaction.
                  laboratory data, to define each                         SIMPLE Cases                                        Completion of       script concordance case
                  patient’s central clinical problem                      Script Concordance Testing                          scenarios to the Program Director’s
                                                                          Direct supervision of work rounds (CMR)             satisfaction.
Clinical
                                                                          Shadow rotation (no credit)                         Satisfactory direct observation of ability to
Reasoning
                  Develop prioritized differential                        Shared call / supervised call                       deliver clinical care with level appropriate
                  diagnoses, evidence based diagnostic                    Written self assessment, including plan for         supervision
                  and therapeutic plan for common
                                                              12          improvement                                         Satisfactory improvement of evaluation
                  inpatient and ambulatory conditions                                                                         metrics in this area
                                                                                                                              No further reports of concern in this regard
                                                                                                                              over the period of this remediation.
                  Make appropriate clinical decisions                      Review basic test indications and                  Direct observation of ability to order and
                  based upon the results of common                         interpretations with mentor / CMR                  interpret basic testing.
                  diagnostic testing, including but not                    Generate “Review Sheets” for basic test            Satisfactory improvement of evaluation
Diagnostic        limited to routine blood chemistries,                    indications and interpretations.                   metrics in this area
tests             hematologic studies, coagulation
                                                              12                                                              No further reports of concern in this regard
                  tests, arterial blood gases, ECG, chest                                                                     over the period of this remediation.
                  radiographs, pulmonary function
                  tests, urinalysis and other body fluids
                  Acquire accurate and relevant history                    Communication Counseling                            Satisfactory completion of      structured
                  from the patient in an efficiently                       Full CEX examinations                               CEX’s
                  customized, prioritized, and
                                                               6           Monitored outpatient interviewing during            Direct observation of ability to obtain a
Historical Data   hypothesis driven fashion                                continuity clinic                                   patient history.
Gathering                                                                  Monitored inpatient interviewing                    Satisfactory improvement of evaluation
                  Seek and obtain appropriate, verified,
                                                                           Written self assessment, including plan for         metrics in this area
                  and prioritized data from secondary          9           improvement                                         No further reports of concern in this regard
                  sources (e.family, records, pharmacy)
                                                                                                                               over the period of this remediation.
                  Recognize situations with a need for                     Review urgent / emergent case scenarios with        Direct observation of the ability to recognize
                  urgent or emergent medical care              6           mentor / CMR                                        situations with a need for urgent / emergent
                  including life threatening conditions                    Generate review sheets on common urgent /           care.
                                                                           emergent case scenarios                             Satisfactory improvement of evaluation
                                                                           Review BLS /ACLS protocols                          metrics in this area
Patient           Recognize when to seek additional
Management        guidance
                                                               6           Written self assessment on need for                 No further reports of concern in this regard
                                                                           supervision / additional help, including plan       over the period of this remediation.
                                                                           for improvement
                                                                           Review USPTF guidelines regarding                   Satisfactory improvement of evaluation
                  Provide appropriate preventive care
                  and teach patient regarding self-care
                                                               6           preventive care with clinic mentor.                 metrics in this area
                                                                           Observed counseling of clinic patients              No further reports of concern in this regard
                                                             regarding preventive and self care.            over the period of this remediation.
                                                                                                            Direct observation of ability to provide
                                                                                                            appropriate preventive care.
                With minimal supervision, manage             Review old M&M cases with mentor               Completion of       essay type level appropriate
                patients with common clinical                Chart reviews of own cases with mentor         case scenarios to the Program Director’s
                disorders seen in the practice of       12   SIMPLE Cases                                   satisfaction.
                inpatient and ambulatory general             Script Concordance Testing                     Completion of       script concordance case
                internal medicine                            Direct supervision of work rounds (CMR)        scenarios to the Program Director’s
                                                             Shadow rotation (no credit)                    satisfaction.
                                                             Shared call / supervised call                  Direct observation of ability to deliver clinical
                With supervision, manage patients
                                                             Written self assessment on patient             care with level appropriate supervision.
                with complex clinical disorders seen
                in the practice of inpatient and
                                                        12   management skills, including plan for          Satisfactory improvement of evaluation
                                                             improvement                                    metrics in this area
                ambulatory general internal medicine
                                                                                                            No further reports of concern in this regard
                                                                                                            over the period of this remediation.
                                                             Review urgent / emergent case scenarios with   Direct observation of ability to recognize and
                                                             mentor / CMR                                   treat situations with a need for urgent /
                                                             Generate review sheets on common urgent /      emergent care.
                Initiate management and stabilize
                                                             emergent case scenarios                        Satisfactory improvement of evaluation
                patients with emergent medical          12   Review BLS /ACLS protocols                     metrics in this area
                conditions
                                                             Written self assessment on management of       No further reports of concern in this regard
                                                             emergent medical conditions, including plan    over the period of this remediation.
                                                             for improvement                                Attain ACLS certification
                Perform an accurate physical                 Review textbook of Physical Exam Skills        Score above a pre-set minimum score on an
                examination that is appropriately            CEX examinations focusing on physical exam     exam testing Physical Exam findings.
                targeted to the patient's complaints         skills                                         Demonstrate satisfactory physical exam skills
                and medical condition. Identify
                                                        6    Physical Exam Skill rotation                   in     CEX’s
Performing a    pertinent abnormalities using                Written self assessment on physical exam       Direct observation of ability to complete a
physical exam   common maneuvers                             skills, including plan for improvement         physical exam.
                Accurately track important changes                                                          Satisfactory improvement of evaluation
                in the physical examination over time                                                       metrics in this area
                in the outpatient and inpatient
                                                        12                                                  No further reports of concern in this regard
                settings                                                                                    over the period of this remediation.
                         Summary

				
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posted:11/11/2011
language:English
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